CalPERS Open Enrollment September 10-October 5, 2018

The CalPERS annual health care Open Enrollment period for the 2019 calendar year starts September 10 and ends October 5, 2018.  During this time, members may enroll in or switch their CalPERS health plan, add eligible dependents, or delete dependents.  New this year is the Open Enrollment app.  Members can head to mobile.my.calpers.ca.gov to explore health plan information from their smartphone or tablet.  All changes made during Open Enrollment become effective January 1, 2019.

2019 Vested Health Premium Rates

The CAPS MOU requires the state to pay 80% of the weighted average of the four largest health plans offered to state scientists by CalPERS. The chart below lists the health plan choices, state’s contribution and out of pocket expenses for each.

CalPERS members (that means YOU) must pay the difference between the state’s contribution amount and the premium for the health plan in which you are enrolled. Health plan premiums vary depending on the configuration of the plan. CalPERS annually negotiates with health plan providers over plan design and premiums.

Details on benefit changes to individual plans will come directly from CalPERS to individual members, or go to the CalPERS website. Open enrollment is held in the Fall, when current members can also elect to change plans. Any such changes would be effective January 1. Open enrollment in the state’s FlexElect program (administered by CalHR) is held at the same time.

STATE CONTRIBUTION SINGLETWO-PARTYFAMILY
20195831,1701,518
20185791,1581,504
PLANSINGLETWO-PARTYFAMILY
ANTHEM HMO SELECT 
 PremiumSingleTwo-PartyFamily
201974314861932
201879715932072
Out-of-Pocket Cost
2019160316414
2018218435568
ANTHEM HMO TRADITIONAL  
 PremiumSingleTwo-PartyFamily
201910342,0692,690
20188411,6832,187
Out-of-Pocket Cost
20194518991,172
2018262525683
BLUE SHIELD ACCESS + HMO  
 PremiumSingleTwo-PartyFamily
20197991,5982,077
20187521,5051,956
Out-of-Pocket Cost
2019216428559
2018173347452
KAISER CA 
 Premium  SingleTwo-PartyFamily
20197081,4171,842
20187171,4351,865
Out-of-Pocket Cost
2019125247324
2018138277361
KAISER Out of State 
Premium  SingleTwo-PartyFamily
20199651,9282,508
20189571,9142,488
Out-of-Pocket Employee Cost
2019382758990
2018378756984
HEALTH NET SALUD Y MÁS  
 PremiumSingleTwo-PartyFamily
2019377754980
20184729431,226
Out-of-Pocket Cost
2019000
2018000
PLANSINGLETWO-PARTYFAMILY
HEALTH NET SMARTCARE  
 PremiumSingleTwo-PartyFamily
20197291,4571,895
20187911,5812,056
Out-of-Pocket Cost
2019146287377
2018212423552
SHARP  
 PremiumSingleTwo-PartyFamily
20195941,1871,544
20186251,2491,624
Out-of-Pocket Cost
2019111726
20184691120
UNITED HEALTHCARE  
PremiumSingleTwo-PartyFamily
20196961,3921,809
20187051,4091,832
Out-of-Pocket Cost
2019113222291
2018126251328
PERS Select  
 PremiumSingleTwo-PartyFamily
20196741,3561,756
20186611,3231,719
Out-of-Pocket Employee Cost
201991186238
201882165215
PERSChoice
 PremiumSingleTwo-PartyFamily
20197651,5301,988
20187241,4481,883
Out-of-Pocket Employee Cost
2019182360470
2018145290379
PERSCare  
 Premium  SingleTwo-PartyFamily
20199301,8602,418
20187761,5522,018
Out-of-Pocket Employee Cost
2019347690900
2018197394514
Western Health Advantage  
 Premium  SingleTwo-PartyFamily
20197071,4141,838
20187201,4411,873
Out-of-Pocket Employee Cost
2019124244320
2018141283369

 

PLEASE NOTE:

In 2019, Blue Shield Access+ will withdraw from eight Bay Area counties:  Alameda, Contra Costa, Marin, San Francisco, San Mateo, Santa Clara, Solano and Sonoma.

Health Net will withdraw from El Dorado, Placer, Sacramento and Yolo counties. 

You may be able to reduce your taxable income by estimating your medical expenses and setting aside out-of-pocket expenses pre-tax via the state’s Medical Reimbursement Program.  This benefit is outlined in the CAPS MOU, Section 5.8 Pre-Tax of Health/Dental/Vision Premiums. It says, in relevant part “employees who are enrolled in any health, dental and/or vision plan which requires a portion of the premium to be paid by the employee will automatically have their out-of-pocket premium cost taken out of their paycheck before federal, state and Social Security taxes are deducted. Employees who choose not to have their out-of-pocket cost pre-tax must make an election not to participate in this program.”

In other words, out-of-pocket costs for health plan premiums are automatically deducted pre-tax, but there is an opportunity to set aside additional pre-tax funds for other anticipated qualified medical expenses. Get more information on the CalHR website.